Apparatus, system and method for performing an electrosurgical procedure

ABSTRACT

A forceps is provided. The forceps includes a housing having a shaft that extends therefrom. The bipolar forceps also includes a hydraulic mechanism that includes a fluid line and a plunger operatively coupled to the fluid line. The plunger is translatable within at least a portion of the shaft from a proximal position to a distal position. An end effector assembly is operatively connected to a distal end of the shaft and includes a pair of first and second jaw members biased in an open configuration. Each of the first and second jaw members configured to receive at least a portion of the plunger when a fluid is caused to flow within the fluid line such that the first and second jaw members move from an open position for positioning to a closed position for grasping tissue.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.13/369,152, filed on Feb. 8, 2012, which is a continuation of U.S.patent application Ser. No. 12/352,942, filed on Jan. 13, 2009, now U.S.Pat. No. 8,114,122. The entire content of each of the applicationsidentified above is incorporated by reference herein.

BACKGROUND

Technical Field

The present disclosure relates to an apparatus, system, and method forperforming an electrosurgical procedure. More particularly, the presentdisclosure relates to an apparatus, system, and method for performing anelectrosurgical procedure that employs an electrosurgical apparatus thatincludes an end effector assembly configured for use with various sizeaccess ports.

Description of Related Art

Electrosurgical apparatuses (e.g., electrosurgical forceps) are wellknown in the medical arts and typically include a handle, a shaft and anend effector assembly operatively coupled to a distal end of the shaftthat is configured to manipulate tissue (e.g., grasp and seal tissue).Electrosurgical forceps utilize both mechanical clamping action andelectrical energy to effect hemostasis by heating the tissue and bloodvessels to coagulate, cauterize, seal, cut, desiccate, and/or fulguratetissue

As an alternative to open electrosurgical forceps for use with opensurgical procedures, many modern surgeons use endoscopes and endoscopicelectrosurgical apparatus (e.g., endoscopic forceps) or laparoscopicapparatus for remotely accessing organs through smaller, puncture-likeincisions or natural orifices. As a direct result thereof, patients tendto benefit from less scarring and reduced healing time. For example, theendoscopic forceps are inserted into the patient through one or morevarious types of cannulas or access ports (typically having an openingthat ranges from about five millimeters to about twelve millimeters)that has been made with a trocar; as can be appreciated, smallercannulas are usually preferred.

Endoscopic forceps that are configured for use with small cannulas(e.g., cannulas less than five millimeters) may present designchallenges for a manufacturer of endoscopic instruments.

SUMMARY

As noted above, smaller cannulas or access ports are usually preferredduring an endoscopic procedure. However, because of size constraints ofthe cannula or access port, endoscopic forceps that are configured foruse with smaller cannulas may present design challenges for amanufacturer (e.g., designing an end effector assembly of an endoscopicforceps without compromising the integrity and/or functionalitythereof).

Therefore, it may prove useful an endoscopic forceps that includes anend effector assembly configured for use with various types of cannulasor access ports including those that are less than five millimeters.With this purpose in mind, the present disclosure provides A forceps isprovided. The forceps includes a housing having a shaft that extendstherefrom. The bipolar forceps also includes a hydraulic mechanism thatincludes a fluid line and a plunger operatively coupled to the fluidline. The plunger is translatable within at least a portion of the shaftfrom a proximal position to a distal position. An end effector assemblyis operatively connected to a distal end of the shaft and includes apair of first and second jaw members biased in an open configuration.Each of the first and second jaw members configured to receive at leasta portion of the plunger when a fluid is caused to flow within the fluidline such that the first and second jaw members move from an openposition for positioning to a closed position for grasping tissue.

The present disclosure also provides a method for performing anelectrosurgical procedure. The method includes the initial step ofproviding an electrosurgical instrument including a hydraulic mechanismthat includes a fluid line and a plunger operatively coupled thereto. Anend effector assembly includes a pair of first and second jaw membersbiased in an open configuration. The method also includes the steps of:positioning tissue between the pair of first and second jaw members;actuating the hydraulic mechanism to cause the first and second jawmembers to move towards each other such that tissue is graspedtherebetween; and applying electrosurgical energy to the jaw memberssuch that a tissue seal may be effected therebetween.

BRIEF DESCRIPTION OF THE DRAWING

Various embodiments of the present disclosure are described hereinbelowwith references to the drawings, wherein:

FIG. 1 is a perspective view of a bipolar forceps including an endeffector assembly and electrosurgical generator according to anembodiment of the present disclosure;

FIG. 2 is a schematic representation of an electrical configuration forconnecting the bipolar forceps to the electrosurgical generator depictedin FIG. 1;

FIG. 3A is an enlarged, front perspective view of the end effectorassembly of FIG. 1 shown in an open configuration;

FIG. 3B is an enlarged, front perspective view of the end effectorassembly of FIG. 1 shown in a closed configuration; and

FIG. 4 is a flowchart illustrating a method for performing anelectrosurgical procedure in accordance with the present disclosure.

DETAILED DESCRIPTION

Detailed embodiments of the present disclosure are disclosed herein;however, the disclosed embodiments are merely exemplary of thedisclosure, which may be embodied in various forms. Therefore, specificstructural and functional details disclosed herein are not to beinterpreted as limiting, but merely as a basis for the claims and as arepresentative basis for teaching one skilled in the art to variouslyemploy the present disclosure in virtually any appropriately detailedstructure.

As noted above, it may prove useful to provide an electrosurgicalapparatus that is suitable for use with various access ports, includingbut not limited to those that are greater than and/or less than fivemillimeters. With this purpose in mind, the present disclosure includesan electrosurgical forceps that includes a hydraulic actuated endeffector assembly having a pair of jaw members that operatively coupleto a hydraulic mechanism that moves the jaw members from an openposition for positioning tissue to a closed position for grasping tissueand causing a tissue effect therebetween. The hydraulic actuated endeffector assembly of the present disclosure provides the needed forcerequired for fusing or sealing tissue when the electrosurgical forcepsis one of in either a non-articulated or articulated configuration.

With reference to FIG. 1 an illustrative embodiment of anelectrosurgical apparatus (e.g., bipolar forceps 10) for performing anelectrosurgical procedure is shown. Bipolar forceps 10 is operativelyand selectively coupled to an electrosurgical generator (generator 200,see FIG. 2 for example) for performing an electrosurgical procedure. Asnoted above, an electrosurgical procedure may include sealing, cutting,cauterizing coagulating, desiccating, and fulgurating tissue all ofwhich may employ RF energy. Generator 200 may be configured formonopolar and/or bipolar modes of operation. Generator 200 may includeor is in operative communication with a system (system 400, see FIG. 2)that may include one or more processors in operative communication withone or more control modules that are executable on the processor. Acontrol module (not explicitly shown) instructs one or more modules totransmit electrosurgical energy, which may be in the form of a wave orsignal/pulse, via one or more cables (e.g., a cable 310) to one or bothof the seal plates 118, 128. For a more detailed description of thegenerator 200 and/or system 300 reference is made to commonly owned U.S.application Ser. No. 10/427,832.

With reference again to FIG. 1, bipolar forceps 10 is shown for use withvarious electrosurgical procedures and generally includes a housing 20,a handle assembly 30, a rotating assembly 80, a trigger assembly 70, adrive assembly 130, and an end effector assembly 100 that operativelyconnects to the drive assembly 130. Drive assembly 130 is in operativecommunication with a hydraulic mechanism 200 for imparting movement ofone or both of a pair of jaw members 110, 120 of end effector assembly100. End effector assembly 100 includes opposing jaw members 110 and 120(FIG. 1) that mutually cooperate to grasp, seal and, in some cases,divide large tubular vessels and large vascular tissues. Although themajority of the figure drawings depict a bipolar forceps 10 for use inconnection with laparoscopic surgical procedures, the present disclosuremay be used for more traditional open surgical procedures or endoscopicprocedures. For the purposes herein, the forceps 10 is described interms of a laparoscopic instrument; however, an open version orendoscopic version of the forceps may also include the same or similaroperating components and features as described below.

Forceps 10 includes a shaft 12, as described in greater detail belowwith reference to FIGS. 3A-3B that has a distal end 14 configured tomechanically engage the end effector assembly 100 and a proximal end 16that mechanically engages the housing 20. In the drawings and in thedescriptions that follow, the term “proximal,” as is traditional, willrefer to the end of the forceps 10 which is closer to the user, whilethe term “distal” will refer to the end that is farther from the user.

With continued reference to FIG. 1, handle assembly 30 includes a fixedhandle 50 and a movable handle 40. Fixed handle 50 is integrallyassociated with housing 20 and handle 40 is movable relative to fixedhandle 50. Fixed handle 50 may include one or more ergonomic enhancingelements to facilitate handling, e.g., scallops, protuberances,elastomeric material, etc.

Movable handle 40 of handle assembly 30 is ultimately connected to driveassembly 130, which together mechanically cooperate to impart movementof hydraulic mechanism 200. Movement of hydraulic mechanism 200 causesjaw members 110 and 120 to move from an open position, wherein the jawmembers 110 and 120 are disposed in spaced relation relative to oneanother, to a clamping or closed position, wherein the jaw members 110and 120 cooperate to grasp tissue therebetween.

Rotating assembly 80 is operatively associated with the housing 20 andis rotatable approximately 180 degrees about a longitudinal axis “A-A”defined through shaft 12 (see FIG. 1).

Forceps 10 also includes an electrosurgical cable 310 that connects theforceps 10 to a source of electrosurgical energy, e.g., generator 200.Cable 310 is internally divided into cable leads 310 a, 310 b, 310 c,and 325 b (see FIG. 2) that are designed to transmit electricalpotentials through their respective feed paths through the forceps 10 tothe end effector assembly 100. More particularly, cable feed 325 bconnects through the forceps housing 20 and through the rotatingassembly to jaw member 120. Lead 310 a connects to one side of a switch(not shown) and lead 310 c connects to the opposite side of the switchsuch that upon activation of the switch energy is transmitted from lead310 a to 310 c. Lead 310 c is spliced with lead 310 b that connectsthrough the rotating assembly to jaw member 110.

For a more detailed description of handle assembly 30, movable handle40, rotating assembly 80, electrosurgical cable 310 (including line-feedconfigurations and/or connections), and drive assembly 130 reference ismade to commonly owned U.S. application Ser. No. 10/369,894.

Turning now to FIG. 3A, shaft 12 includes distal end 14 operativelyconnected to end effector assembly 100 and hydraulic mechanism 200.Shaft 12 is configured to house drive assembly 130 and hydraulicmechanism 200 or portions thereof. At distal end 14 of shaft 12, jawmembers 110 and 120, or portions thereof, are attached to an innersurface of shaft 12 via any suitable attaching means including but notlimited to staking, welding, riveting, molding or overmolding.

Distal end 14 of shaft 12 is adapted to provide reciprocation of one ormore plungers 202 and/or a knife blade 212 of hydraulic mechanism 200.Additionally, distal end 14 is configured to allow jaw members 110 and120 to pivot from an opened to closed configuration, during translationof the plungers 202 therein (as explained in more detail below). A sealor sealing structure (not explicitly shown), such as a gasket, may beoperatively disposed at or near the distal end 14 of shaft 12 andconfigured to provide a substantially fluid tight seal between endeffector assembly 100 and plunger 202.

With continued reference to FIG. 3A, hydraulic mechanism 200 is shown.Hydraulic mechanism 200 includes a fluid line 204 that is in fluidcommunication with one or more of the plungers 202. Hydraulic mechanism200 (and components associated therewith) may be made from any suitablebio-compatible material.

Fluid line 204 includes one or more suitable bio-compatible fluids “F”therein. Fluids “F” suitable for use with fluid line 204 of hydraulicmechanism 200 may include synthetic compounds, mineral oil, water, andwater-based mixtures. Fluid line 204, and/or fluid “F” containedtherein, is in operative communication with the drive assembly 130,plunger 202, and/or distal end 14 of shaft 12 by way of one or moresuitable internal connections and/or components. Internal mechanicallycooperating components associated with the drive assembly 130 and/orfluid lines 204 impart movement of the jaw members 110, 120 of endeffector assembly 100. Suitable components include any number of vacuumboosters or servos, cylinders, pistons, drums, gears, links, valves,springs, and/or rods such that forceps 10 may function as intended. Whena force is applied to one or more components (e.g., piston) associatedwith the hydraulic mechanism 200, pressure in the hydraulic mechanismincreases, forcing the fluid “F” through the fluid line 204 to the oneor more plungers 202.

Plunger 202 is in operative communication with the fluid line 204 and/orfluid “F” such that the plunger 202 is selectively translatable from aproximal position to a distal position (e.g., engaged with one or bothof the jaw members 110, 120) within shaft 12. In the embodimentsillustrated in FIGS. 3A and 3B, plunger 202 is shown operativelydisposed at a distal end 14 of shaft 12 and adjacent to a proximal endof each of the jaw members 110, 120. Plunger 202 includes a proximal endthat defines a base 208 that includes one or more prongs 210 (two prongs210 are shown) extending therefrom and configured to engage one or morecorresponding apertures 112, 122 located at proximal ends of one or bothof the jaw members 110, 120, respectively. Prongs 210 extendlongitudinally from the base 208 of plunger 202 and are disposed in asubstantially parallel relation to one another. One or more springs 206bias plunger 202 in a proximal orientation. As shown in the illustratedFIGS., spring 206 is operatively disposed on plunger 202. However, insome embodiments, spring 206 may be operatively coupled to the proximalends of the jaw members 110, 120 and/or end effector assembly 100.

In the embodiments illustrated in FIGS. 3A and 3B, plunger 202 includesa plunger 212 that operatively couples to a knife blade or cutter 212that is translatable within a knife channel 401 operatively disposed onone or both of the jaw members 110, 120. Plunger 212 is movable relativeto the plunger 202 from a proximal position to a distal position and isconfigured to translate the knife to transect or severe tissue after atissue effect has been achieved.

End effector assembly 100 includes opposing jaw members 110 and 120 thatare fixedly attached shaft 12. Jaw members 110, 120 may be operativelyand pivotably coupled to each other and located adjacent the distal end14 of shaft 12.

Jaw member 110 includes an insulative jaw housing 117 and anelectrically conductive seal plate 118 (hereinafter seal plate 118). Theinsulator 117 is configured to securely engage the electricallyconductive seal plate 118. This may be accomplished by stamping, byovermolding, by overmolding a stamped electrically conductive sealingplate and/or by overmolding a metal injection molded seal plate. All ofthese manufacturing techniques produce an electrode having a seal plate118 that is substantially surrounded by the insulating substrate. Withinthe purview of the present disclosure, jaw member 110 may include a jawhousing 117 that is integrally formed with a seal plate 118.

Jaw member 120 includes a similar structure having an outer insulativehousing 127 that may be overmolded to capture seal plate 128.

Each of the jaw members 110, 120 is configured to engage a respectiveprong 210 of plunger 202 such that each of the jaw members 110, 120 aremovable from an open position, wherein the jaw members 110 and 120 aredisposed in spaced relation relative to one another, to a closedposition, wherein the jaw members 110 and 120 cooperate to grasp tissuetherebetween. With this purpose in mind, each of the jaw members 110,120 include respective apertures 112, 122 located at proximal endsthereof. Apertures 112, 122 extend within each of the jaws 110, 120,respectively, a distance that allows the prongs 210 of plunger 202 totranslate therein such that jaw members 110, 120 are caused to move fromthe open to the closed position. A substantially fluid tight sealstructure may be operatively disposed with the apertures 112, 122 andconfigured to maintain a constant pressure within the fluid line 204. Asnoted above, a portion of the proximal ends of each of the jaw members110, 120 may include structure that engages or contacts the spring 206.

In use, prior to sealing tissue, jaw members 110 and 120 are initiallybiased in an open configuration (FIG. 3A). A user may position tissuebetween the jaw members 110, 120. When tissue is properly positionedbetween the jaw members 110, 120, a user may activate the hydraulicmechanism 200, for example, by way of movable handle 40. When themovable handle 40 is moved proximally, leverage (provided by linkagesystem, not explicitly shown) may multiply the force (provided by themovable handle 40 moving proximally) to one or more componentsassociated with the hydraulic mechanism 200 (e.g. piston, not explicitlyshown). The applied force to the piston increases pressure in the fluidline 204 of the hydraulic mechanism 200, which causes fluid “F” to flowthrough the fluid lines 204 to the plunger 202. This fluid flow causesthe plunger 202 to translate distally within the shaft 12 and/or fluidline 204. This translation of plunger 202 causes the prongs 210 toengage the apertures 112, 122 of proximal end jaw members 110, 120,respectively, which, in turn, cause the jaw members 110, 120 to movefrom the open position to the closed position, wherein the jaw members110, 120 cooperate to grasp tissue.

Once tissue has been grasped (FIG. 3B), a user may activate generator200, for example, via button 60, such that a desired tissue effect maybe achieved (e.g., a tissue seal). After the desired tissue effect hasbeen achieved, a user may release the moveable handle 40, which, inturn, causes the movable handle 40 to move distally. This distalmovement of movable handle 40 releases some, if not all, of the pressurebuilt up in the fluid line 204 such that the plunger 202 under thebiasing force of the spring 206 is caused to move proximally and out ofengagement with the apertures 112, 122 of jaw members 110, 120,respectively, and, thus, back to their initial open position.

In some embodiments, after a desired tissue effect has been achieved, auser may also activate the knife blade 212 to transect or sever theeffected tissue. More particularly, while tissue is grasped between thejaw members 110, 120 and the plunger is in a distal position, a usermay, for example, apply additional pressure to the movable handle 40such that the plunger 212 is caused to translate distally. In thisinstance, plunger 202 is maintained in a fixed position via the proximalend of the jaw members 110, 120 and the plunger 212 is free to translatewithin the knife channel 400 such that tissue may be severed.

From the foregoing and with reference to the various figure drawings,those skilled in the art will appreciate that certain modifications canalso be made to the present disclosure without departing from the scopeof the same. For example, a pneumatic mechanism may be employed insteadof a hydraulic mechanism 200. In this instance, the pneumatic mechanism,and operative components associated therewith, would mutually cooperateto function in a manner as described hereinabove with reference to thehydraulic mechanism 200.

The present disclosure also provides a method 500 for performing anelectrosurgical procedure. As illustrated in FIG. 5, at step 502 abipolar forceps is provided. At step 504, tissue is positioned betweenthe pair of first and second jaw members such that a tissue seal may beeffected. At step 506, the drive assembly is actuated to move theactuation tube causing the cam pin to cam the first and second jawmembers to pivot about the living hinge and cam towards each other suchthat tissue is grasped therebetween. And at step 508, electrosurgicalenergy is applied to the jaw members such that a tissue seal may beeffected therebetween.

While several embodiments of the disclosure have been shown in thedrawings, it is not intended that the disclosure be limited thereto, asit is intended that the disclosure be as broad in scope as the art willallow and that the specification be read likewise. Therefore, the abovedescription should not be construed as limiting, but merely asexemplifications of particular embodiments. Those skilled in the artwill envision other modifications within the scope and spirit of theclaims appended hereto.

What is claimed is:
 1. A forceps comprising: a housing; a shaftextending distally from the housing and defining a longitudinal axis; afirst plunger disposed within the shaft; a hydraulic mechanismoperatively associated with the first plunger and configured totranslate the first plunger along the longitudinal axis; and an endeffector assembly positioned at a distal end of the shaft and includingfirst and second jaw members moveable relative to one another between anopen configuration and a clamped configuration, each of the jaw membersdefining an aperture configured to receive a portion of the firstplunger when the first plunger is translated distally to move the firstand second jaw members towards the clamped configuration.
 2. The forcepsaccording to claim 1, further comprising a second plunger operativelyassociated with the hydraulic mechanism, the hydraulic mechanismconfigured to translate the second plunger along the longitudinal axis.3. The forceps according to claim 2, wherein the second plunger isconfigured to selectively engage at least one of the first and secondjaw members to sever tissue clamped between the first and second jawmembers when the first and second jaw members are in the clampedconfiguration.
 4. The forceps according to claim 2, wherein the secondplunger includes a knife blade coupled thereto that is translatablethrough a knife slot defined within at least one of the first and secondjaw members.
 5. The forceps according to claim 2, wherein the secondplunger is translatable relative to the first plunger.
 6. The forcepsaccording to claim 2, wherein the second plunger is translatableindependent of the first plunger.
 7. The forceps according to claim 1,wherein the first and second jaw members are biased towards the openconfiguration.
 8. The forceps according to claim 1, wherein each of thefirst and second jaw members is pivotable about a pivot pin located atthe distal end of the shaft.
 9. The forceps according to claim 1,wherein the first plunger includes two prongs extending from a proximalend thereof, one of the two prongs engaging the aperture of the firstjaw member and the other of the two prongs engaging the aperture of thesecond jaw member when the first plunger is translated distally.
 10. Theforceps according to claim 1, further comprising a biasing memberoperably disposed on the first plunger and configured to bias the firstplunger proximally.
 11. A forceps comprising: a housing; a shaftextending distally from the housing and defining a longitudinal axis; aplunger assembly disposed within the shaft and including first andsecond plungers; an end effector assembly positioned at a distal end ofthe shaft and including first and second jaw members moveable relativeto one another between an open configuration and a clampedconfiguration; and a hydraulic mechanism operatively associated with thefirst and second plungers and configured to translate the first andsecond plungers along the longitudinal axis, the first plungerconfigured to engage the first and second jaw members to move the firstand second jaw members toward the clamped configuration when the firstplunger is translated distally along the longitudinal axis, the secondplunger operatively associated with a knife and configured to translatethe knife along the longitudinal axis, wherein each of the first andsecond jaw members defines aperture and the first plunger is configuredto selectively engage the aperture of each of the first and second jawmembers when the first plunger is translated distally to move the firstand second jaw members towards the clamped configuration.
 12. Theforceps according to claim 11, wherein the second plunger istranslatable relative to the first plunger.
 13. The forceps according toclaim 11, wherein at least one of the first and second jaw membersdefine a knife channel and the second plunger is configured to translatethe knife through the knife channel as the second plunger is translateddistally.
 14. The forceps according to claim 11, wherein the first andsecond jaw members are biased towards the open configuration.
 15. Amethod for performing an electrosurgical procedure, the methodcomprising: positioning tissue between first and second jaw members ofan electrosurgical instrument; actuating a hydraulic mechanism of theelectrosurgical instrument to move the first and second jaw memberstowards each other such that tissue is grasped therebetween, whereinactuating the hydraulic mechanism includes engaging an aperture definedin at least one of the first and second jaw members with a first plungerof the hydraulic mechanism; applying electrosurgical energy to the jawmembers to electrosurgically treat the grasped tissue; and reactuatingthe hydraulic mechanism to sever the treated tissue.
 16. The methodaccording to claim 15, wherein the first and second jaw members arebiased towards an open configuration.
 17. The method according to claim15, wherein reactuating the hydraulic mechanism to sever the treatedtissue includes translating a second plunger of the hydraulic mechanismdistally.
 18. The method according to claim 17, wherein translating thesecond plunger of the hydraulic mechanism distally includes translatingthe second plunger relative to the first plunger.